Objective To estimate the ability of MSCTA in displaying internal mammary artery . Methods MSCTA images of clinically suspected aortic disease in 30 patients were retrospectively re-processed and analyzed.The transverse images were combined with the reorganization images to observe the running rule,length and diameter of internal mammary artery.Results 60 internal mammary arteriae were showed by MSCTA,one was maldevelopment and obvious smaller than that of the contralateral one,four in two patients were obvious circuitous and two in one patient appeared abnormal branch.All internal mammary arteries originated from the outside of the first segmental of the left and right subclavian artery respectively,and descended along the back of the upper 6 sostal cartilages,in the distance of 2 cm to the limbus of sternal border,then divided into two in the sixth intercostal space level.56 on anterior view showed straight line descent,while on lateral view,they closed to the costal cartilage and were mild-circuitous.The average length of internal thoracic arteries was:(20.11?1.85) cm in right and (20.34?1.57) cm in left, the average diameter was:(2.49?0.37) cm in right and (2.45?0.35) cm in left.Conclusion MSCTA can clearly demonstrate the internal mammary artery,which provides various kinds of information for the clinical diagnosis and treatment of certain diseases.

Objective To estimate the value of MSCTA in the diagnosis of subclavian arterial stenosis.Methods 10 patients with suspected subclavian steal syndrome which causes subclavian artery stenosis underwent MSCTA, the contrast medium was Iohexol 80~90 ml, the flow rate was 3~4 ml/s with sure-star techniques,excretory-phase images were transferred to the workstation and shaded volume rendering (VR),multiplanar reconstruction(MPR),and curved planar reconstruction (CPR) were performed.The left subclavian artery was divided into proximal and distals by openning of left vertebral arteries. Results The narrowing positions:6 cases were in proximal and 4 cases were in distal of subclavian artery.6 cases were focal stenosis,4 cases were multiple stenosis and totally 14 focus.The extent of stenosis was 0.8~2.0 cm,10 cases were ≤1 cm and 4 cases were 1.1~20 cm.The degree of stenosis included 7 cases ≤50%,3 cases in 50%~70%.The results was same comparing with that of DSA.Conclusion MSCTA plays an important role in diagnosing subclavian arterial stenosis.

Objective To observe the protective effects of short-term continuous subcutaneous insulin infusion (CSⅡ) therapy on the peripheral blood circulating endothelial progenitor cells (EPCs) in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and its antioxidation mechanism. Methods Forty T2DM patients (T2DM group) and 30 controls (control group) were involved in this study. Density gradient centrifugation was used to collect peripheral blood mononuelear cells. After 7 days' inducement and differentiation, FITC-UEA and DIL-acLDL double staining cells were identified to be differentiated EPCs by laser scanning conform microscope, and they were counted under inverted microscope. Serum levels of reactive oxygen species (ROS), malondialde-hyde (MDA), glutathione (GSH), superoxide dismutase (SOD) were examined. Results In T2DM group, the EPCs in peripheral blood were significantly reduced (46 ± 3 vs 23 ± 4, P< 0.01), BOS and MDA increased[(1125 ± 687) U/ml vs(2088 ± 765) U/ml, (4.58 ±3.03) μ mol/L vs (8.32 ± 4.15) μ mol/L, P < 0.01] , and GSH and SOD decreased [(263 ± 35) mg/L vs (206 ± 41) mg/L, (103 ± 7) U/ml vs (80 ± 15) U/ml, P < 0.05] . EPCs were negatively correlated with BOS and MDA (r = -0.7352,P < 0.01 ;r = -0.8454, P < 0.01) and was positively correlated with GSH and SOD (r =0.5435,P <0.05;r =0.6437,P <0.05). After short-term CSⅡ therapy, EPCs, GSH, and SOD in patients with T2DM significantly increased (P < 0.05),but BOS and MDA significantly decreased (P <0.05). Conclusion Short-term CSⅡ therapy can significantly reduce oxidative stress in patients with T2DM, promote the restoration of EPCs, and then prevent vascular disease.

Objective To study diagnosis and treatment of rhabdomyosarcoma (RMS) in children.Method The clinical data of 43 children with RMS was retrospectively reviewed from Nov 2004 to May 2012.Their long-term survival was followed up.Forty-three children with RMS(male 26,female 17) in Beijing Tongren Hospital were enrolled.Their median age on diagnosis was 6 years old.We confirmed the diagnosis according to pathological diagnosis.Comprehensive treatment included chemotherapy,surgery and implantation of radioactive seeds,and so on.Statistical analysis was used on clinical data and treatment efficacy.Result The median follow up time of 43 cases with RMS in children was 31 mouths until May 2012.Four cases abandoned,39 cases were followed up.The cases of complete remission were 27(69％),and the cases of partly remission were 7 (18％),and the cases of dead were 5 due to cerebral metastasis.Overall survival rate was 87％ (34/39).Eight cases were treated with 125Ⅰ particles implants into its location,7 cases responded,1 case was invalid.Conclusion Although anatomic structure of RMS of head and neck was very complex,and the prognosis of it with metastatic disease was inferior,the muttidisciplinary treatment can still improve the clinical remission rate.In particular,high risk RMS with 125Ⅰ particles implants and large dose chemotherapy would be beneficial.

Objective To investigate the clinical characteristics,treatment and prognosis of hepatoblastoma (HB) patients with the central nervous system (CNS) metastasis.Methods The clinical data of 12 patients with CNS metastasis who were admitted to Beijing Tongren Hospital,Capital Medical University from January 2011 to June 2016 were retrospectively analyzed.The clinical features,treatment and prognosis of HB patients with CNS metastasis were summarized.Results (1) Clinical features:all 12 patients were diagnosed as stage-Ⅳ patients according to postoperative Children's Oncology Group (COG) stage system.The primary positions of extrahepatic metastatic characteristics were as follows:lung metastasis in 12 cases,bone metastasis in 3 cases,and adrenal metastasis in 2 cases,right atrial metastasis in 1 case,and abdominal lymph node metastasis in 1 case.Fetal and epithelial mixed type was the most common type in pathologic Pathologic classification of HB (50％,6/12 cases).CNS metastasis was detected in all 12 cases during the course of treatment.Brain metastasis were found in 11 cases of CNS imaging features,and 1 case had spinal metastatic tumors.(2) The treatment for CNS metastasis:all cases were given chemotherapy-based comprehensive treatment after being diagnosed as CNS metastasis of HB.Ten cases of CNS metastasis were treated by maintenance chemotherapy and 2 cases received chemotherapy plus intracranial tumor resection.(3) The prognosis of HB with CNS metastasis:the follow-up time was from 7 months to 54 months in 12 HB cases with CNS metastasis,and the median follow-up time was 20 months.The survival time of HB was 1-15 months,and the median survival time was 3.5 months after the diagnosis of CNS metastasis.Two cases of CNS metastasis were given intracranial tumor resection and chemotherapy and were followed up to June 2016,and survival time was 15 months and 5 months respectively.The survival time of other 10 cases without intracranial surgery was 1-6 months,and the median survival time was 3 months.By drawing survival function curve and applying Log-Rank test for CNS transfer children,the survival time of patients given intracranial tumor resection and chemotherapy was longer than those without surgery (P ＜ 0.05).Conclusions The occurrence of CNS metastasis occurred in HB patients in phase-Ⅳ patients with pulmonary metastasis.The most common site of CNS metastasis is brain metastasis,which is hematogenous metastatic pathway,and 1 case of spinal cord metastasis was considered as the local invasion and metastasis.For HB cases with CNS metastasis,the survival time is short and the prognosis is poor,but the survival time might be prolonged for the phase-Ⅳ patients with intracranial tumor resection.

Objective To investigate the applicability of Cys C-based formulas for prediction of GFR in Chinese patients with CKD.Methods A total of 176 adult patients with CKD including 90 males and 86 females collected from 4 hospitals located in different geographic regions of China (Beijing,Shanghai,Dalian and Changsha) were enrolled in this study from September 2007 to July 2009.The rGFR was measured using 99mTc-DTPA clearance rate two-sample method.Cystantic C was measured by PETIA and PENIA respectively.The results of eGFR in the Larsson formula,Grubb formula,Hoek formula,Filler formula,Stevens formula and Hojs formula were compared with the rGFR to evaluate the calculation coherence,bias,precision,accuracy and the performance of correct phasing of the formulas.Results The mean 99mTc-DTPA clearance was [40.70 ( 19.09 - 86.49)] ml · min-1 · ( 1.73m2 ) -1.Significant difference was witnessed in the evaluation of GFR estimation formulas calculated by PETIA and PENIA (P ＜0.01).ICC and Spearman correlation analysis revealed a significant correlation between eGFR and rGFR.The ICCs of eGFR and rGFR ranged from 0.874 to 0.938.Compared with rGFR,the 30％ accuracy of all the eight evaluation formulas using PETIA and PENIA method were lower than 60％.The percentages of correct phasing in all the 5 stages of CKD were not ideal.With these formulas,percentages of correct phasing from CKD stage 2 to CKD stage 4 were lower than 65％.The eGFRs were underestimated by formulas evaluated by PENIA in CKD stage 1.All the eGFRs were overestimated remarkably by all equations in CKD stage 5.Conclusions None of the eight Cys C based formulas are ideal for estimation of GFR in Chinese CKD patients,and they can not be applied to Chinese patients directly.For this patient population,further studies will be needed to develop a more accurate Cys C-based GFR estimation formula that includes ethnicity,age and other factors.

Objective To investigate the accuracy of three-dimensional ultrasound volumetric measurements for children's bladder. Methods The bladder volumes of 238 children aged 9 months to 16 years (male:106;female:132) in Shenzhen Children's Hospital underwent real-time three-dimensional ultrasound for volume measurements. These cases were divided into six groups according to the body surface area:(0.36~0.60) m2 (27 cases), (0.61~0.78) m2 (66 cases), (0.79~0.89) m2 (52 cases), (0.90~1.05) m2 (33 cases), (1.06~1.20) m2 (30 cases) and (1.21~1.78) m2 (30 cases). The bladder volume measured by GE Voluson E8 and Philips iU22 were compared with the actual volumes of discharge urine. The relation between bladder volume measurements and the actual volume of discharge urine was analyzed. Results Children's bladder volume increasesd with the body surface area (F=33.53, P<0.05) and showed positive correlations with the body surface area (r=0.679, P <0.05). Compared with the actual volume of discharge urine, each group's bladder volume measurements obtained by three-dimensional ultrasound were lower and the results were as follows:[(47.80±30.33) ml vs (82.24±49.63) ml, (77.20±39.72) ml vs (139.98±79.03) ml, (95.96±50.79) ml vs (175.96±101.70) ml, (117.46±54.17) ml vs (206.62±86.22) ml, (145.53±73.60) ml vs (253.33±135.09) ml and (220.27±110.34) ml vs (327.42±165.45) ml]. The differences between children's bladder volume measurements and the actual volume of discharge urine were statistically significant (t=3.19, 5.53, 5.08, 4.49, 3.84 and 3.00, all P <0.05), but children's bladder volume showed positive correlations with the actual urine volume (r=0.881, P<0.05). The bladder volume measurements by spheroid formula based on two-dimensional ultrasound are lower than the actual volume of discharge urine, and the results were as follows:[(50.38±36.94) ml vs (82.24±49.63) ml, (86.77±62.34) ml vs (139.98±79.03) ml, (102.69±60.21) ml vs (175.96±101.70) ml, (107.94±55.14) ml vs (206.62±86.22) ml, (145.31±66.01) ml vs (253.33±135.09) ml and (222.77±132.59) ml vs (327.42±165.45) ml]. The differences were statistically significant (t=3.03, 4.01, 4.47, 4.95, 3.94 and 2.75, all P <0.05), but children's bladder volume showed positive correlations with actual urine volume (r=0.326, P <0.05). Conclusions Three-dimensional ultrasound volumetric measurements for children's bladder is feasible and in clinical application, the factors of children's growth should be take into account. Combing regression equation, children's bladder volume can be more accurately quantified.

Objective To evaluate the biological characteristics of hip joint in infants with developmental dislocation of the hip (DDH).Methods From January 2013 to June 2016,30 patients (age from 1 to 8 months,25 females and 5 males) who were diagnosed as DDH,underwent ultrasound examination in Shenzhen Children's Hospital,in these patients 20 cases were treated surgically,and 10 cases were treated with non-surgical treatment.There were 34 hips (26 unilateral dislocation and 4 bilateral dislocation) dislocation in 60 hips.All the patients were confirmed by X-ray,magnetic resonance imaging (MRI) examination or operation.All the patients were examined by ultrasound through the coronal and transverse plane of the hip joint.The α angle,femoral head coverage ratio by acetabulum (FHC),femoral head length and width,distance from pubis to femoral head (P-H) and distance from ischium to femoral head (I-H) were measured.The dislocation joints were compared with contralateral joints.Results The α angle in the hip dislocation group was smaller than the contralateral group [(50.5±3.75)° vs (64.8±3.38) °],and there was significant difference between the two groups (t=-15.181,P ＜ 0.001).The FHC,femoral head length and width in the hip dislocation group were all smaller than the contralateral group [(23.4t17.63)％ vs (64.3±6.45)％,(0.98 ±0.15) cm vs (1.19 ±0.11) cm,(1.38±0.21) cm vs (1.61 ±0.16) cm],and there were significant differences between the two groups (t=-12.469,-6.034,-4.568,all P ＜ 0.001).The P-H and I-H in the hip dislocation group were larger than the contralateral group [(0.97±0.45) cm vs (0.27±0.05) cm,(0.75±0.30) cm vs (0.17±0.05) cm],and there were significant differences between the two groups (t=8.805,10.696,both P ＜ 0.001).The α angle,femoral head length and width in bilateral dislocation of hip group were slightly smaller than the unilateral dislocation of hip group [(50.3±2.75)° vs (51.3±4.77)°,(0.90 ±0.15) cm vs (0.97 ±0.12) cm,(1.25±0.20) cm vs (1.37 ±0.17) cm],but there were no significant differences between the two groups.The P-H and I-H in bilateral dislocation of hip group were slightly larger than the unilateral dislocation of hip group [(0.97 ± 0.49) cm vs (0.80±0.31) cm,(0.92±0.26) cm vs (0.68±0.18) cm],but there were no significant differences between the two groups.The value of acetabular index in the ultrasound group was slightly larger than the X-ray group [(33.13 ± 7.82)° vs (31.20 ± 8.31)°],and there were no significant differences between the two groups.Conclusions The characteristics of DDH includes acetabulum and femoral head dysplasia,and femoral head and acetabulum position relationship abnormalities.Quantitative ultrasonography of the hip can be used to quantitatively evaluate the structural features of DDH,and it is helpful to the early diagnosis and follow-up of DDH.

OBJECTIVETo study the clinicopathologic and immunohistochemical features of diffuse large B-cell lymphoma (DLBCL) and the significance of immunohistochemistry in diagnosis and differential diagnosis of DLBCL.

METHODS60 cases of DLBCL were studied and immunohistochemical staining for LCA, L26, BLA-36, CD30, bcl-6 were carried out with the EnVision 2 step method.

RESULTSThe age range of 76.7% (46/60) patients was 40 - 70 years. The location of the lesion includes nodal and extranodal sites. 90.0% (54/60) were in clinical stages of II (24/54), III (21/54), IV (9/54). Histopathologic morphology presented as centroblastic (88.3%, 53/60), immunoblastic (3.3%, 2/60), anaplastic large B cell type (3.3%, 2/60) and T cell rich B cell type (5.0%, 3/60). Immunostaining showed 100% (60/60) DLBCL were positive for LCA, L26, BLA36, 3.3% (2/60) DLBCL positive for CD30, 95% (57/60) expressed bcl-6 protein.

CONCLUSIONSDLBCL is an aggressive lymphoma which shows cytologic variability from case to case. The evaluation of pathologic features and immunohistochemistry in DLBCL are useful and practical for diagnostic purposes, but cannot delineate distinctive morphologic subtypes.

Adult ; Aged ; Antigens, CD20 ; analysis ; DNA-Binding Proteins ; analysis ; Female ; Humans ; Immunohistochemistry ; Ki-1 Antigen ; analysis ; Leukocyte Common Antigens ; analysis ; Lymphoma, B-Cell ; metabolism ; pathology ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Male ; Middle Aged ; Proto-Oncogene Proteins ; analysis ; Proto-Oncogene Proteins c-bcl-6 ; Transcription Factors ; analysis

Objective To analyze the clinical features,treatment and prognosis of the pancreatoblastoma (PB).Methods A total of 9 patients including 4 boys and 5 girls diagnosed as pancreatoblastoma in Beijing Tongren Hospital Affiliated to Capital Medical University between July 2008 and February 2016 were enrolled.The clinical features,therapy and prognosis were analyzed.Results (1) Clinical manifestations:6 cases had abdominal mass,1 case had jaundice,2 cases had abdominal pain at the time of diagnosis;5 cases were found in caput pancreatis,2 cases were found in corpora pancreatis and 2 cases were found in cauda pancreatis;4 cases had local tumor,3 cases had local invasion,and 2 cases had liver metastasis at diagnosis.(2) Enzymology and tumor marks:elevated alpha-fetoprotein (AFP) was found in 5 cases (48.5-52 971.0 μg/L),elevated neuron-specific enolase(NSE) was found in 5 cases(22.4-53.4 pg/L),elevated carbohydrate antigen 125 (CA-125) was found in 5 cases [(40.3-122.8) × 103 U/ L],elevated carbohydrate antigen 19-9 (CA19-9) was found in 2 cases [(65.4-362.5) × 103 U/ L],elevated lactate dehydrogenase was found in 2 cases(380 ～ 838 U/L) and elevated hemodiastase was found in 2 cases (105.5-122.8 U/L).(3) Treatment and prognosis:in 9 patients,the tumors were resected at first in 6 patients,and 5 of them remitted until now,1 of them relapsed after the comprehensive treatment for 9 months.Two of the patients underwent operation after the chemotherapy,in which 1 case received complete resection but without chemotherapy after the surgery,whom relapsed 1 year later;and the other one was resected partly.But after stopping the comprehensive treatment for 6 months,the disease relapsed.One patient could not receive operate because of huge tumor size,and the chemotherapy failed to control tumor progression;the patient died without operation.Three relapsed children were still in chemotherapy.The median follow-up period was 21 months (8-98 months).Conclusions AFP may be used as monitoring indicator for PB.Complete tumor resection is an important factor affecting the outcome.Adjuvant chemotherapy may reduce recurrence and prolong survival.